A pilot study of radiation therapy combined with daily low-dose cisplatin for esophageal cancer.
A pilot study of radiation therapy combined with daily low-dose cisplatin for esophageal cancer.
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放射治疗联合每日低剂量顺铂治疗食管癌的初步研究。
DOI：
10.3892/or.8.4.785
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发表时间：
2001
期刊：
影响因子：
4.2
通讯作者：
Y. Hosoi
中科院分区：
文献类型：
--
作者：
K. Nemoto;Y. Ogawa;H. Matsushita;K. Takeda;C. Takahashi;H. Saito;Y. Takai;S. Yamada;Y. Hosoi
自1992年3月至1997年10月，38例经组织学证实的食道癌患者接受了每日小剂量顺铂(CDDP)联合放射治疗。临床分期(UICC1997)：I期3例，IIA期，B期13例，III期13例，IVA期9例。CDDP(5 mg/m2)在周一至周五每次照射前30min静脉滴注生理盐水100ml。所有患者都接受了至少60Gy射线的放射治疗。平均给药次数为23次，平均总剂量为115 mg/m2。在38例患者中，14例完成了全程放化疗。总的1、2、5年生存率分别为51%、19%、8%。中位生存期为12个月。客观有效率82%，CR11例(29%)。接受每日小剂量顺铂和放射治疗的II-IVA期患者的存活率略好于仅接受放射治疗的历史对照患者。大多数患者都有恶心的症状。2例(5%)患者出现3级食管炎。4级白细胞减少者1例(3%)，胸腺细胞减少者2例(5%)。除白细胞减少(18%)外，3级及以上毒性发生率均小于10%。虽然结果表明，每日小剂量顺铂联合放射治疗可能会在毒性可接受的情况下略微改善食道癌患者的生存，但仍需进一步努力优化临床试验方案。应考虑增加顺铂的日剂量，以获得更有效的放射增敏作用。
From March 1992 to October 1997, a total of 38 patients with histologically proven esophageal cancer received combination therapy of daily low-dose cisplatin (CDDP) and radiation therapy. The clinical stages (UICC 1997) were I in 3, IIA,B in 13, III in 13, and IVA in 9 patients. CDDP (5 mg/m2) was administered intravenously with 100 ml saline 30 min before each irradiation from Monday to Friday. All patients received at least 60 Gy of radiation therapy. The average number of CDDP administrations was 23, and the mean total CDDP dose was 115 mg/m2. Of the 38 patients, 14 patients completed full course of chemoradiation therapy. The overall survival rates at 1, 2, and 5 years were 51%, 19%, and 8%, respectively. The median survival period was 12 months. The objective response rate was 82% with 11 (29%) CR. Survival of the stage II-IVA patients who received daily low-dose CDDP and radiation therapy was a little better than that of historical control patients who were treated by radiation therapy alone. Most of the patients experienced nausea. Grade 3 esophagitis was observed in two (5%) patients. Grade 4 leukocytopenia and thorobocytopenia were observed in one (3%) and two (5%) of the patients, respectively. Except for leukocytopenia (18%), frequencies of toxicity of grade 3 or more were less than 10%. Although the results indicate that daily low-dose CDDP combined with radiation therapy may slightly improve the survival of esophageal cancer patients with acceptable toxicity, further efforts should be made to optimize clinical trial protocols. Escalation of daily CDDP dose should be considered to obtain a more effective radiosensitizing effect.